Supportive therapies in ano-rectal diseases--are they really useful?

Epidemiological features of proctological disease are not well known because available studies have provided variable conclusions. Risk factors frequently mentioned include heredity, high socioeconomic level, obesity, smoking, a diet rich in fats, alcohol, spices and pepper as well low fluid intake have all been implicated. While treating patients with various ano-rectal pathologies, apart from definitive treatment, various additional or supportive therapies are being advised both by the family physicians and surgeons. These include local applications, sitz baths, modification in the diet and life style. But are these supportive therapies really beneficial or they are just empirical? This paper elaborates the various supportive therapies advocated in the common anal disorders like hemorrhoids, anal fissure and fistula and summarizes the advantages and pitfalls of these treatment additives.